Background

There is little evidence to predict patient outcomes after the treatment of high-risk cutaneous SCC (hrSCC) using Mohs micrographic surgery (MMS).

Objective

We sought to report the rates of poor outcomes in patients with hrSCC treated by MMS alone and to determine if any specific clinical factors may be more predictive of these outcomes.

Methods

We conducted a retrospective chart review of all patients with hrSCC who were treated in our clinic between October 2011 and December 2015.

Results

We identified 647 hrSCC tumors that met the inclusion criteria. During the follow-up period, there were 19 local recurrences (2.9%), 31 nodal metastases (4.8%), 7 distant metastases (1.1%), and 7 disease-specific deaths (1.1%). Two factors, poor differentiation and invasion beyond the subcutaneous fat, were positively associated with local recurrence, nodal metastasis, and disease-specific death through multivariate analysis.

Conclusions

Invasion beyond the subcutaneous fat and poor histologic differentiation may carry a greater risk of poor outcomes than other factors in hrSCC. MMS alone provides excellent marginal control with low rates of local recurrence, nodal metastasis, and disease-specific death.

中文翻译：

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仅接受Mohs显微外科手术治疗的高危鳞状细胞癌患者的临床结局

背景

很少有证据可以通过Mohs显微外科手术（MMS）预测高危皮肤SCC（hrSCC）后的患者预后。

客观的

我们试图报告仅通过MMS治疗的hrSCC患者不良预后的发生率，并确定是否有任何特定的临床因素可以更好地预测这些预后。

方法

我们对2011年10月至2015年12月间在我们诊所接受治疗的所有hrSCC患者进行了回顾性图表审查。

结果

我们确定了647例符合纳入标准的hrSCC肿瘤。在随访期间，有19例局部复发（2.9％），31例淋巴结转移（4.8％），7例远处转移（1.1％）和7例因疾病而死亡（1.1％）。通过多变量分析，皮下脂肪以外的分化和侵袭性差这两个因素与局部复发，淋巴结转移和疾病特异性死亡呈正相关。

结论

与hrSCC中的其他因素相比，皮下脂肪以外的浸润和组织学差的分化可能带来不良结局的更大风险。单独的MMS可以提供​​出色的边缘控制，且局部复发，淋巴结转移和疾病特异性死亡的发生率低。